FACE-Q Eye Module for Measuring Patient-Reported Outcomes Following Cosmetic Eye Treatments

JAMA Facial Plast Surg. 2017 Jan 1;19(1):7-14. doi: 10.1001/jamafacial.2016.1018.


Importance: Aesthetic eye treatments can dramatically change a person's appearance, but outcomes are rarely measured from the patient perspective. The patient perspective could be measured using an eye-specific patient-reported outcome measure.

Objective: To describe the development and psychometric evaluation of FACE-Q scales and an adverse effect checklist designed to measure outcomes following cosmetic eye treatments.

Design, setting, and participants: Pretreatment and posttreatment patients 18 years and older who had undergone facial aesthetic procedures were recruited from plastic surgery clinics in United States and Canada and completed FACE-Q scales between June 6, 2010, and July 14, 2014. We used Rasch Measurement Theory, a modern psychometric approach, to refine the scales and to examine psychometric properties.

Main outcomes and measures: The FACE-Q Eye Module, which has 4 scales that measure appearance of the eyes, upper and lower eyelids, and eyelashes. Scale scores range from 0 (worst) to 100 (best). The module also includes a checklist measuring postblepharoplasty adverse effects.

Results: Overall, 233 patients (81% response rate) 18 years and older participated. Adverse effects included being bothered by eyelid scars, dry eyes, and eye irritation. In Rasch Measurement Theory analysis, each scale's items had ordered thresholds and good item fit. Person Separation Index and Cronbach α were greater than or equal to 0.83. Higher scores on the eye scales correlated with fewer adverse effects (range, -0.26 to -0.36). In the pretreatment group, older age correlated with lower scores (range, -0.42 to -0.51) on the scales measure appearance of the eyes and upper and lower eyelids. Compared with the pretreatment group, posttreatment participants reported significantly better scores on the scales measuring appearance of eyes overall, as well as upper and lower eyelids.

Conclusions and relevance: The FACE-Q Eye Module can be used in clinical practice, research and quality improvement to collect evidence-based outcomes data.

Level of evidence: NA.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Blepharoplasty / adverse effects
  • Blepharoplasty / psychology*
  • Checklist
  • Evidence-Based Medicine
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Psychometrics / statistics & numerical data*
  • Reproducibility of Results
  • Surveys and Questionnaires*
  • Treatment Outcome